AN ACT

 

1Amending the act of June 2, 1915 (P.L.736, No.338), entitled, as
2reenacted and amended, "An act defining the liability of an
3employer to pay damages for injuries received by an employe
4in the course of employment; establishing an elective
5schedule of compensation; providing procedure for the
6determination of liability and compensation thereunder; and
7prescribing penalties," further providing for schedule of
8compensation.

9The General Assembly of the Commonwealth of Pennsylvania
10hereby enacts as follows:

11Section 1. Section 306(f.1)(3)(vi) of the act of June 2, 
121915 (P.L.736, No.338), known as the Workers' Compensation Act, 
13reenacted and amended June 21, 1939 (P.L.520, No.281) and 
14amended June 24, 1996 (P.L.350, No.57), is amended to read:

15Section 306. The following schedule of compensation is
16hereby established:

17* * *

18(f.1) * * *

19(3) * * *

1(vi) (A) The reimbursement for [prescription] drugs and
2professional pharmaceutical services shall be limited to one
3hundred [ten<-] per centum of the average wholesale price (AWP) of
4the product, calculated on a per unit basis, as of the date of 
5dispensing.

6(B) A physician seeking reimbursement for drugs dispensed by
7a physician shall include the original manufacturer's National
8Drug Code (NDC) number, as assigned by the Food and Drug
9Administration, on the bills and reports required under this
10section.

11(C) In no event may a physician seek reimbursement in excess
12of one hundred<- ten per centum of the AWP of the drugs dispensed
13by a physician as determined by reference to the original
14manufacturer's NDC number.

15(D) A repackaged NDC number may not be used and will not be
16considered the original manufacturer's NDC number. If a
17physician seeking reimbursement for drugs dispensed by a
18physician does not include the original manufacturer's NDC
19number on the bills and reports required by this section,
20reimbursement shall be limited to one hundred<- ten per centum of
21the AWP of the least expensive clinically equivalent drug,
22calculated on a per unit basis.

23(E) No outpatient provider, other than a <-licensed pharmacy
<-24licensed in this Commonwealth or another state, may seek
25reimbursement for drugs dispensed in excess of an initial<- five-
26day <-fifteen-day supply, commencing upon the employe's initial
27treatment following injury. Reimbursement shall be made for such
28five-day fifteen-day supply at the rates set forth in this<-
29section.

30(F) No outpatient provider, other than a pharmacy licensed<-
 

1in this Commonwealth or another state, may seek reimbursement 
2for an over-the-counter drug.

<-3(F) (G) For purposes of this subclause, clinical
4equivalence, in reference to a drug, means the drug has chemical
5equivalents which, when administered in the same amounts, will
6provide essentially the same therapeutic effect as measured by
7the control of a symptom or a disease.

8* * *

9Section 2. This act shall take effect in 60 days.